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PubMed1998

Historical clues to the diagnosis of the dysfunctional child and other psychiatric disorders in children.

This article focuses on selected historical clues that can help the busy pediatrician identify children who are at risk for or already suffering from psychosocial dysfunction. Certain historical elements have been chosen because they reveal either common areas of childhood dysfunction or potentially dire outcomes. The major function realms of a child's life are covered, such as family, school, peer relationships, activities, and emotions, as well as related topics such as injury, poverty, substance abuse, and risk-taking behavior. Questions designed to elicit the relevant historical clues are suggested. Used as a set, these questions are intended to bring to light sufficient psychosocial history for pediatricians to identify most dysfunctional children.

Child↗
PubMedDate not supplied

The effect of the sex of interviewers on the quality of data in a Nigerian family planning questionnaire.

Traditionally, female interviewers have been preferred to men for conducting fertility and family planning surveys. However, in West Africa, evidence for their superiority over male interviewers is mixed. In Nigeria, as part of a four-state pretest of the national family planning questionnaire, an experimental design was incorporated to quantify effects of the sex of the interviewer. In one state, reinterviews were also performed to measure the reliability of responses. In the conservative northern state of Kano, the use of male interviewers was problematic. However, in the other three states, only weak evidence was found to mitigate against the use of male interviewers. In fact, in two states, the proportion of respondents reporting knowledge of several contraceptive methods was significantly higher when male interviewers conducted the survey. Respondents' reports of contraceptive use were very unreliable for interviewers of both sexes.

Adolescent↗
PubMed1997

Injury prevention counseling in an urban pediatric clinic. Analysis of audiotaped visits.

OBJECTIVE: To determine the content of injury prevention counseling (an expected component of pediatric anticipatory guidance) and the communication methods used with data from an urban pediatric clinic that serves low-income families. DESIGN: Audiotapes of well-child visits with 52 pediatric residents were analyzed for 178 children aged 0 to 4 years. A specific coding methodology was developed to analyze counseling by injury topics, prevention strategies, and communication methods. RESULTS: Less than half (ie, 47%) of the visits included injury prevention counseling. During the 83 visits that included counseling, an average of 1.96 injury topics were discussed. The average time spent on injury topics was 1.08 minutes per visit and 33 seconds per injury topic. An average of 2.68 prevention strategies were mentioned, although a statement specifically recommending their use was made for only 35% of the prevention strategies. The most frequently discussed injury topics were ingestion, falls, and pedestrian safety, house fires and firearms were never discussed. The most frequently mentioned prevention strategies were storing dangerous substances and items out of reach, using cabinet locks, calling the poison-control center, having outlet covers, using stair gates, and using car seats. Information-giving by the resident was the most frequently used communication method. Physician elicitation of information from parents was associated with more parental participation in the discussion. CONCLUSIONS: Pediatric residents in this sample spent little time discussing injury prevention, and problems thought to be important to the specific population being served were never mentioned. Communication methods to enhance compliance other than eliciting and giving information (ie, soliciting feedback, obtaining a commitment, and giving reinforcements) were rarely or never used. Priorities need to be defined so that the most important injury prevention topics and strategies are discussed effectively in the limited time available. Further research about pediatric injury prevention counseling is needed to examine the feasibility and effect of resident training in communication methods that enhance compliance.

Adolescent↗
PubMedDate not supplied

Cross-cultural considerations in the conduct of community-based participatory research.

This article explores cross-cultural challenges that arise when university and community members collaborate in community-based participatory research. As part of a project for primary prevention of human immunodeficiency virus (HIV) infection, researchers trained community leaders to jointly develop a research question and conduct a pilot qualitative study in a Puerto Rican community in Massachusetts. Different priorities of the community and university members about HIV as a research topic underscored the need to continuously reflect on developing a research question in community-based participatory research. Recognizing the cultural assumptions of both university and community members is an important component of capacity building among collaborative research teams.

Community-Institutional Relations↗
PubMed1989

Childbearing and women's choice of nurse-midwives in Washington, D.C. hospitals.

This research focuses on the extent to which choosing a certified nurse-midwife (CNM) for the management of birth in the hospital is an option. Licensing laws affect this option by determining access to hospitals for CNMs in the form of hospital practice privileges. Data for this descriptive case study of Washington, D.C. hospitals were collected from interviews with CNMs and hospital personnel, including physicians, and from secondary sources, including legislative acts and hospital bylaws. Our findings suggest that although the option for a CNM managed birth has increased in the District with the granting of hospital privileges to CNMs in 3 of 9 hospitals providing obstetrical services, restrictions on CNM practice still exist. These are the capacity to admit patients in the CNMs' name and the issue of supervision of CNMs by a physician in the hospital.

Delivery, Obstetric↗
PubMed1979

Interprofessional communicability and reliability of the Comprehensive Psychopathological Rating Scale (CPRS) as assessed by video-taped interviews.

Five raters: two experienced psychiatrists, two psychologists (one acquainted with the use of the scale and one new to it) and an untrained social worker, participated in training sessions in the use of the CPRS. Videotaped interviews were used for assessing the level of inter-rater reliability and the communicability of the CPRS to unexperienced raters. As in previous studies, it was found that the CPRS is easily communicable and that a very satisfactory level of agreement among raters can be achieved.

Evaluation Studies as Topic↗